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  • About
  • For HCPs
    • Prescribing information
    • Coverage restrictions
    • Prior authorization
    • Financial assistance
    • Sample requests
  • For Practices
    • Practice collaboration
    • Rep Management
  • For brands
    • Claim your page
    • Brand activation
    • Rep Connect
  • About

Find the latest sample request forms

Easily find prescription medication sample request forms with a few steps

Sample Requests

Seamlessly request medication samples

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Search by drug

Search by drug and click the “Samples” button in the menu.

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Find sample forms

Find and share sample forms with a few clicks.

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Request more support from our chatbot or trained staff to help you find what you need.

Sample Request Challenges

Medication samples start treatment promptly

Medication samples can support evaluating treatment efficacy, start therapy promptly, and improve patient compliance; however, the logistics can be challenging.

$13.5 billion

is invested into sample distribution in the US.
[1]
Source: National Institutes of Health

92%

of US physicians have accepted drug samples.
[2]
Source: National Institutes of Health

 

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